By Andrew Martin
The covid-19 pandemic currently has 22 million confirmed cases and has killed over 800 000 people. The virus continues to surge. There is barely any place in the world that has not been affected. Its epicentres are the Americas, the U.S, India and most of Europe. It continues to rise through parts of Asia and has swept the Caribbean and even parts of Oceania.
Capitalism is amazingly efficient at spreading the disease through all its transit systems. Many countries will be feeling the effects of the virus economically for decades. Iran and many Latin American countries have been crippled by the virus. Where energy, food and running water are precious commodities, the virus will strike the hardest and it shows no sign of slowing.
It took 38 days for cases to go from five to ten million, but only 20 days in August to go from 15 to 20 million. The trajectory is exponentially up. The IMF has said the world is now in the worst recession since the Great Depression of the 1930s and the UN has said 265 million people may face starvation due to the impact of the virus.
To some, this appears apocalyptic: the end of days. For the sake of perspective, it’s worth considering that this is not the first global pandemic humanity has faced and it is probably not the worst. In 1918, the Spanish Flu (which originated in the U.S) lasted for two years, infecting 500 million people and killing an estimated 20 to 50 million. Fully, 1/3 of the worlds population contracted the deadly disease. Pre-capitalist pandemics were even worse.1
Although it provides perspective, the past is a brutal guide in how to deal with today’s pandemic. There are very visible and clear lessons now, that shine a light on a pathway out of disease and economic crisis. Cuba, an impoverished and besieged country has been battling covid-19 since mid-March. It has taken a different approach to that of its northern neighbour, the U.S which is belligerently heading into a downward spiral of putting profits before life. Already 180 thousand people are dead in the U.S, with almost six million infected. In what is the richest country on the planet this record appears as a callous disregard for life. The deaths are a symptom of an empire that has reached the peak of its arrogance.
By contrast Cuba is poor, has few material resources and remains cut-off from the world by the longest economic blockade in modern history. It is a small island nation less than 150km from the mightiest and most violent global power to have ever ruled. Despite all this Cuba is still able to provide a positive example of how to handle the pandemic.
Cuba offers solidarity
Cuba’s most valuable resource is its solidarity and its cooperation which gives it strong social-cohesion and a focus on preserving life above all other priorities. For example, Cuba was the only country not to turn away the British cruise ship, the MS Braemar which docked in the Port of Mariel in March, just as the covid-19 was sweeping the world. For a week the ship had sought a port of refuge. The U.S and every other Caribbean port had turned it away.
Many on board were wealthy tourists from Britain, a country not known for friendly relations with Cuba. All 600 passengers were bussed to safety, assessed, treated and repatriated. Why would Cuba make such a gesture to inhabitants of a traditionally hostile nation? The answer is simple. Cuba’s government knows that solidarity is required to halt the pandemic. Doctor Alberto Fernandez speaking on behalf of the Cuban government stated:
“We Cubans are proud to stand up in a situation like this. We are convinced and sure we can deal with anything that comes up as we did with Ebola. Cuba has shown repeatedly it can deal with complicated situations and come out successfully”.
That is not to say Cuba is immune from the virus. Far from it. The first casualty in Cuba, which relies heavily on tourism for survival was an Italian tourist. Since then, 88 people have died from the virus in Cuba. The scale of the pandemic is also a serious economic threat to Cuba which is struggling without the tourist dollar. Nevertheless Cuba still sends support to countries that most need it.
Its medical brigades have even gone to much richer countries, such as Italy. Cuba sent 34 medical teams throughout the world to battle covid-19. Destinations included the Caribbean, Latin America, the Middle East, Africa and for the first time, Europe. The Henry Reeve International Medical Brigade of 3,500 doctors (over 60% are women) will continue to provide solidarity throughout the world to areas affected by the pandemic.
Cuba has been sending doctors around the world for many years. In 2005 Fidel Castro named the brigades the Henry Reeves Brigade after hurricane Katrina swept through the Gulf of Mexico, smashing New Orleans to pieces. Cuba was one of the first country’s to offer aid. Castro offered U.S president George W. Bush the use of 1 600 doctors and 36 tonnes of medicine and medical equipment to respond to the disaster.
Bush rejected the offer, but the brigades were not left standing idle. They have travelled throughout the world from Nepal, Guatemala and Africa where they gained valuable experience dealing with the Ebola epidemic. They have helped in the most dangerous epidemics and disasters. They were the last international doctors to leave Kashmir, when in 2005 it was hit by an earthquake that displaced 2.8 million people.
In Lombardy, Italy, the doctors, carrying Cuban flags and a large portrait of Fidel Castro were welcomed as heroes with chants of “Hasta La Victoria Siempre!” (Towards the Victory Always!). Having received training from the World Health Organisation (WHO) on how to diagnose and treat covid-19, they operated in field hospitals set up by the Italian army. The teams helped replace overworked and infected Italian health professionals in cities that had lost tens of thousands of lives.
Contrast this to the approach the U.S has taken towards the pandemic. Trump was quick to blame China for the spread of the covid-19 throughout Italy. Trump tweeted on April 19:
“When I closed up our border, when I did the ban on China, they say a lot of the people that didn’t come in here went to Italy. You’ve heard that. That’s why Italy was hit so hard.”
There was zero evidence of this claim. In fact Italy closed its borders to China before the U.S had imposed its own border restrictions. Moreover, Trump still allowed tens of thousands of people tofly between China and the U.S through a series of exemptions, whereas Italy had imposed a hard lock-down.
US Health and Human Services (HHS) Secretary, Alex Azar briefed Donald Trump at his Mar-a-Lago resort in Florida on 18 January about how quickly the virus could spread. Trump had not put in place travel restrictions until 31 January. In the month before, 380 000 people had flown to and from the U.S. It took several more weeks until flights from Europe were restricted, as if somehow the virus only had a Chinese nationality. Indeed, he continued to call it a “Chinese virus”, well after it swept the globe and has made bashing China a central rallying cry in his re-election campaign.
The potential for exponential growth, was not taken seriously or understood by Trump. When there were only a few hundred cases throughout various states in the U.S, he saw no reason for alarm. He continued to travel abroad. In India he met Prime Minister Narendra Modi and addressed crowds of tens of thousands of admirers. It was while he was there that the CDC released a report detailing the dangers of covid-19. The stock-market plunged and Trump flew home in a rage.
“We have the best people in the world”
On 26 February, Trump replaced Azar with Mike Pence to oversee the response to the pandemic. “Whatever happens, we are totally prepared, we have the best people in the world.” Trump told reporters at the White House. But the message was clear. Anyone who criticised Trump’s response would be pushed aside. The first death from the virus occurred three days later in Seattle.
Asked if there was anything Americans should do to change their routines or their daily lives, Trump responded furiously that such questions were scaremongering and bad reporting. There were health officials who called for a stronger response. Nancy Messonier, the respiratory disease chief of the CDC broke ranks and stated publicly “it’s not a question of if, but when” the virus will spread. She said to prepare for school closures and shut-downs of workplaces.
Trump repudiated these remarks and asserted that cases were “going to be down to close to zero”. CDC director Robert Redfield, backed Trump stating “the risk is low” and that “people need to go on with their normal lives”. It was not until 13 March, that Trump declared the virus a national emergency.
Italy’s response may have been poor, but it was also unlucky. There were direct flights from Wuhan to Milan to feed its massive textile industries with labour and its possible the virus may have spread this way. It’s known the virus was transmitted to Milan on 23 January from two tourists who were asymptomatic.
Instead of focussing on stopping the spread of the virus, Trump used the pandemic to shore up military agreements with Italy, strengthening Italy’s alliance with the U.S in Libya, Mali, Iraq and Afghanistan. This was important for Trump as there are divisions within the Italian ruling coalition parties about Italy’s diplomatic and trade relations with China.2
Doctors in Italy were more concerned with saving lives. Well before the pandemic spread to the U.S, Britain, Australia and other Western powers, Italian doctors warned against failing to put in place social distancing and lock-downs.
Italy should’ve served as a warning
Writing in April’s Journal of the American College of Cardiology, Italian doctors Ciro Indolfi and Carmen Spaccarotella stated “The Italian crisis provoked by COVID-19 is the most serious event in Italian history after World War II. It is a national human, health, and economic tragedy.”
An anonymous Italian doctor appealed to the British tabloid Newsweek at the beginning of March writing:
“I’m a doctor in a major hospital in Western Europe. Watching you Americans (and you, Brits) in these still-early days of the coronavirus pandemic is like watching a familiar horror movie, where the protagonists, yet again, split into pairs or decide to take a tour of a dark basement.”
“The real-life versions of this behaviour are pretending this is just a flu; keeping schools open; following through with your holiday travel plans, and going into the office daily.”
“This is what we did in Italy,” the writer continued.
“We were so complacent that even when people with coronavirus symptoms started turning up, we wrote each off as a nasty case of the flu. We kept the economy going, pointed fingers at China and urged tourists to keep travelling. And the majority of us told ourselves and each other: this isn’t so bad. We’re young, we’re fit, we’ll be fine even if we catch it.”
In the US, the healthcare system failed to provide adequate amounts of ventilators to New York and other cities. The states were in a bidding war with each other for medical equipment and PPE. Trump had left each state to defend for itself. The situation in New York was carnage. Health workers were dying. Bodies were stored in refrigerated trucks and then buried in mass graves.
Compounding the problem was a lack of testing. Because of shortages, the Centers for Disease Control (CDC) limited testing, at first to only those who came from China. While the poor were pushed away, because their symptoms didn’t meet the criteria to get tested, the rich, celebrities and other VIPs had no such difficulty. Further compounding the problem was the insistence of the CDC to only use U.S manufactured testing kits. These turned out to be faulty as one of the components in the test was contaminated, meaning millions of kits had to be re-manufactured under stricter controls. Trump refused to allow testing kits made available from the WHO to be used. Manufactured in Germany, they had already proven to be effective.
Just as in Italy, critical medical supplies had to be rationed. While the pandemic, has to a certain degree stabilised in Italy, it is out of control in the U.S. Rome is now safer than many sparsely populated small towns in the mid-west.
Rather than tackle the pandemic as a public health crisis, Trump has in every way conceivable, politicised it. This has made a disciplined and ordered response to the crisis impossible. The sheer scale of the crisis has been compounded by individual states seeking to reopen the economy as quickly as possible. Trump and Republican governors have refused to heed the advice of public health professionals.
Intensifying the disorder is the promotion of conspiracy theories, quack doctors, right-wing mobs demonstrating against the lock-down, mysticism and unproven drugs such as hydroxychloroquine. Even the wearing of face-masks has become politicised, with Trump refusing to wear one for months. Trump has backed governors who pushed laws to outlaw the wearing of face-masks being made compulsory. The current administration in the White House is the worst possible government to have at the worst possible time. It has sown deep divisions in U.S society that will linger long after the pandemic has receded.
As Italy has shown, even without such problems, the pandemic is difficult to control, but even Italy, one of the most politically fractious country’s on the planet has led a better response than the U.S under Trump. There was nothing inevitable about the dark descent of US society into mass avoidable death. It may also have occurred even under a Democratic federal government. Even the most liberal ruling institutions of the U.S are blinded by arrogance.
According to the Nuclear Threat Initiative and the John Hopkins Center for Health Security, in October 2019, the U.S was best prepared to face any pandemic. It apparently led the world in controls to detect and prevent infectious disease. No doubt, it has the best technology and infrastructure to deal with the virus, but the measures that could’ve prevented the spread of the virus were not put in place, were politically sabotaged or were implemented in a state of total chaos.
In 2018 Trump disbanded the National Security Council’s pandemics team and cut the budget of the CDC. The pandemic response was shifted to the Department of Health and Human Services, a body that had no capacity to coordinate a national response.
The reality, was the U.S was infected at the very top with a toxic arrogance that would make even the worst of Roman emperors and medieval kings blush. Somehow the administration thought a disease that ravaged whole provinces in China and parts of Europe would bypass the U.S. Present in their minds was simply that they are the best – at everything. In terms of response to this pandemic they are the worst.
The race for a vaccine
You can be forgiven for thinking the U.S presidential election might offer signs of hope; that long lasting solutions might be mapped out in the face of such a crisis. But the alternative capitalist ruling party, the Democrats have made it quite clear they are defenders of the status quo. Without a major rebellion and upheaval, the healthcare system will remain in private hands. In the presidential campaign, Biden attacked the idea of universal healthcare:
“With all due respect for Medicare for All, you have a single-payer system in Italy — it doesn’t work there.”
This Trump like remark couldn’t have been more off the mark. Biden conflated the failure of the Italian government to contain the virus with the failure of its public healthcare system which was overwhelmed by the pandemic. The Italian government, led by Guiseppe Conte, failed to put in place a lock-down and coordinate a national response to the pandemic. Conte, an independent, presides over a coalition between the rightwing populist Five-Star Movement and the Centrist Democratic Party. Until mid-2019 Conte had governed in coalition with hardline racist Mateo Salvini. It was left to provincial mayors to put in place restrictions, some of them taking to the streets themselves to castigate those violating orders to stay home.Only on 9 March, after 366 deaths had been recorded, was an Italy-wide lock-down implemented. There has since been over 35 000 more deaths. The situation was truly dire. People were dying on the street. There were not enough beds, let alone ventilators as ambulances queued outside hospitals full of dead bodies.
Italy would have suffered far more if the costs of healthcare weren’t socialised. Hundreds of thousands of tests were conducted and tens of thousands of people were able to recover, thanks to a healthcare system that is provided mostly free of charge to its citizens – even if the quality of care varies greatly between regions.
As in every capitalist country with a public healthcare system, there is an ongoing fight for funding and to keep it in public hands. The National Health Service (Servizio Sanitario Nazionale – SSN) was established in 1978, but in the last two decades has suffered from austerity. According to the World Health Organisation, between 1997 and 2015, the number of intensive care beds in Italy more than halved, from 575 per 100,000 people to 275. Even without these cuts it is likely that Italy would still have needed solidarity from Cuba and other nations to meet the challenges of the pandemic.
Solidarity runs against the grain of the capitalist system, even when it is needed the most. Trump and Biden have both stated that the pandemic is an opportunity to unleash the power of the private sector. As millions of people are suffering, biotech, diagnostics and pharmaceutical giants are rubbing their hands together with glee in the race to find a vaccine. The U.S ruling class are banking on being the first to discover a vaccine to gain economic and strategic advantage, but it may already be losing the race.
In April there were already 70 companies and research teams around the world working on a vaccine. By now there are many hundreds. Usually it takes 10 to 15 years to get a vaccine to market. The WHO has said the most optimistic estimate is that it will take at least two years. There are also tests being conducted to use pre-existing drugs to treat the virus.
Because the U.S, the epicentre of the world economy has failed to contain the virus, a vaccine will be necessary before the world can enter an economic recovery. China already has three vaccines in advanced stages of development. One vaccine developed by CanSino is reportedly already undergoing trials on large numbers of members of the PLA. The two others are being developed by SinoVac and SinoPharm. One thing that has hampered China’s development of a vaccine is that they have been very effective at containing the virus, limiting tests of active cases in humans.
China has at least 13 enterprises that can manufacture a vaccine. However, in order for these vaccines to be successful, China will still need international assistance to improve the reliability of the vaccine, its quality, storage and distribution. In the very least, it needs to be able to trial its vaccine where there are large outbreaks on control groups of tens of thousands of people. It will need data and cooperation with clinical trials globally that comply with strict international standards before the vaccine can be made freely available.
Russia, too has developed a vaccine, Sputnik V. Although there are promises of mass production, it has reportedly not been tested in late-stage, large, randomised control trials. The same is true of vaccines developed in the U.S and Britain. Any vaccine that is developed will need international cooperation for them to be effective.
CUBA’S VACCINE TESTING
Cuba has also developed a vaccine, Sovereign 01 which is undergoing early-stages of testing. Three of the vaccine’s researchers have received the vaccine and have shown a high immune response. The general director of the state run Finlay Institute of Vaccines, Vicente Verez Bencomo said the vaccine presents “low risks, few uncertainties and encouraging results” in the pre-clinical phase, according to Prensa Latina, the Cuban state news agency.
The trial will be a “double blind trial”, meaning doctors and participants will not know who gets the control dosages. Like other Cuban vaccines, it is based on immunotherapy, inducing neutralising anti-bodies. The vaccine will be trialled on 676 adults aged between 19 and 80 years old. Its side-effects and toxicity will be evaluated. Unlike other trials of vaccines, the Finlay Institute have promised to make their findings publicly available.
The willingness to cooperate is what sets Cuba apart. If Cuba does find a vaccine first, then it won’t be the first time the small island nation has led the world in medical research. For instance Cuba has already developed a proven vaccine for lung cancer. It’s not freely available globally, due to the sanctions on Cuba. Thanks to Trump’s escalation of the sanctions (that the US has maintained against Cuba for 60 years) it is illegal for U.S citizens to even travel to Cuba to receive it.
Why would a poor country like Cuba go to so much trouble to develop a vaccine, especially when only a relatively small number of people in Cuba have suffered from the virus? Again the answer is simple. Solidarity. Every decision the government in Cuba makes is based on this principle.
Cuba, besieged by an empire, poor, isolated, derided by liberals and even some socialists in the West, provides a positive example of how the world could have responded to the pandemic. In the first place, Cuba moved decisively to deal with the pandemic. In terms of contact tracing and testing, Cuba leads the region.
Cuba put in place a full lockdown halting international travel and with the exception of essential workers and suspended all urban transport. The armed forces used military vehicles to spray the streets with Chlorine. A moratorium was placed on mortgage repayments and utility bills. The state which dominates the economy ensured people were still paid their wages.
The mass testing and contact tracing was accompanied by house to house social work across the whole island to ensure people’s needs were met. The Minister of Health, Dr. José Ángel Portal, explained the strategy was: “… not wait for the virus to appear, but to go out and look for it.”
Cuba’s centrally planned state run economy can respond quickly to national emergencies. Living under the US economic blockade is not easy for Cuba’s people – especially during the pandemic. However, this experience means Cubans are familiar with living under conditions of hardship and have been able to develop organisational structures needed to reduce the impact of this. The state also provides universal healthcare free of charge. With 95 000 doctors, Cuba has the world’s highest ratio of doctors to population of any country and Cuban life expectancy surpasses the U.S while infant mortality is lower.
But Cuba also needs solidarity. It has meagre amounts of hard currency. Each test-kit for covid-19 costs the government $50 US. A country as poor as Cuba, can’t afford to completely shut-down and its current restrictions are hard to maintain. The virus is extremely infectious, threatening to spark new outbreaks. In mid June it looked like Cuba had overcome the virus. Apart from Havana, all the provinces were free of infection, but in the two weeks prior to 22 August, 181 new cases were detected. The virus has reappeared in large workplaces where the government struggled to provide basic protective equipment and sanitation, due to a lack of supplies.
The U.S has intensified aggression towards Cuba during the pandemic. Right-wing regimes in Bolivia, Ecuador and Brazil have bowed to pressure and expelled Cuban doctors. In all these countries covid-19 has surged and there are calls for their return. The U.S state department has accused Cuba of using the doctors as forced labour and has dissuaded other countries from using them. It is in the process of preparing sanctions on any country that uses Cuban doctors. Given that Cuban doctors are in over 60 countries around the world, this would be a terrible blow in fighting the pandemic.
In most cases, host country’s only pay for the living expenses of the doctors. Only the richer countries provide Cuba with desperately needed foreign exchange for their services, but it is hardly large sums of money. What the Trump administration can’t stand, is the threat of a good example – a government that recognises global cooperation and solidarity are the best weapons against the pandemic.
Although its achievements at battling covid-19 are commendable, Cuba needs the solidarity of much richer nations to help it through the pandemic. It’s imperative that socialists and progressives in the rich countries who are hostile towards Cuba, re-evaluate this and seek instead to understand it.
1. The bubonic plague, otherwise known as the Black Death, a bacteria spread by fleas, wiped out an estimated 1/3 of Europe in the 14th century. It gave birth to rebellions that shattered feudal ruling orders. The Roman empire was also wracked by disease. The Roman emperor Lucius Verus was killed by the Antonine plague in 169 AD. The plague spread along all the trade routes and roads of the empire. It lasted 15 years, caused up to 2 000 deaths a day in Rome and wiped out 1/3 of the population of ancient Rome. It devastated the Roman legions and brought an end to the bloody and intractable conquest of Germania. The disease, thought to have been smallpox or measles may also have spread to China and India. It cracked an empire, which fell into its worst state of internal strife and decadence thereafter, descending into civil war and eventually being destroyed by barbarian invasions.
2. Last year Italy signed an agreement with Beijing that gave the China Communications Construction Company (CCCC) a role in the redevelopment of the ports of Trieste and Genoa. The deal was couched as part of the China’s “Belt and Road” initiative. However, on August 24 the US Department of Commerce announced that a new round of sanctions would target 24 state owned enterprises including the CCCC which puts new pressure on the deal.